Sex change via sex reassignment surgery is a process in which a person's physical characteristics are changed to reflect the sex opposite of that determined at birth.

For sex changes completed in Colorado, you must submit forms JDF 76 and 77 specifying sex change by surgical procedure.

Vital Statistics Board of Health Rule Update including the Amendment of the Sex Designation. On Dec. 19, 2018, the Board of Health approved the proposed changes to "5 CCR 1006-1, Vital Statistics". The revised rule is set to be effective on Feb. 14, 2019.

The State Registrar shall change the sex designation pursuant to a request made under Section 5.5(C)(2) only once during an individual's lifetime. Any further amendment to the sex designation on a birth record or certificate requires a court order pursuant to Section 5.5(C)(1).